Time-course changes in multiparametric magnetic resonance imaging following focal cryotherapy for localized prostate cancer: Initial experience

Abstract

PurposeTo evaluate the time-course changes of multiparametric MRI findings following focal cryotherapy for localized prostate cancer. MethodsSixteen patients who underwent focal cryotherapy as an initial curative treatment for localized prostate cancer during March 2017–April 2021 were included. Before the treatment, the patients underwent targeted prostate biopsy using MRI–transrectal ultrasound fusion. Overall, 64 MRIs were conducted after focal cryotherapy and the temporal post-treatment MR signal changes of the ablated area in T2WI, T1WI, DWI, and DCE-MRI were analyzed. ResultsTechnical success was achieved in all patients. The median follow-up period was 22 months. The initial post-treatment MRI revealed significant signal changes in the target lesions for all patients, including the disappearance of findings suggestive of cancer. At 3 months post-treatment, most lesions were hyperintense with a hypointense rim on T2WI, T1WI, and DWI (83.3 %). After 6 months, hyperintensity reduced, and after 17 months, all lesions showed hypointensity in these sequences. DCE-MRI of most patients showed loss of internal enhancement; however, one patient exhibited residual nodular enhancement in the ablated area at 3 months, which disappeared after 6 months. Peripheral enhancement was common at 3 months, disappearing after 23 months. Two patients showed biopsy-evidenced local recurrence. The recurrent lesions showed hypointensity on T2WI with diffusion restriction and early contrast enhancement in the ventral transition zone. ConclusionMRI findings of the ablated sites following focal cryotherapy for localized prostate cancer show dynamic signal changes, especially within the first 6 months.